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General NPI Number Information
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NPI Number | 1528456621
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Entity Type | Organization
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Legal Business Name | LA RED HEALTH CARE
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Dates
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Enumeration Date | 12/26/2014
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 23659 SAULSBURY LN
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City | GEORGETOWN
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State | DE
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Zip | 19947-6388
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Country | US
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Telephone | 757-709-5072
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Fax | 302-856-1747
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Provider Business Mailing Address
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Address Line | 23659 SAULSBURY LN
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City | GEORGETOWN
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State | DE
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Zip | 19947-6388
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Country | US
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Telephone | 757-709-5072
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Fax | 302-856-1747
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Authorized Official
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Title or Position | LPN
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Name | MAGALI TELLEZ BLANCAS
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Credential |
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Telephone | 757-709-5072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | L2-0012396
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License Number State | DE
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